IDENTIFICATION OF PATHOGENIC & PROGNOSTIC HIGH RISK FACTORS IN TETANUS

ONE YEAR EXPERIENCE

Abstract

Objectives: To pick up high risk determinants and factors influencing the outcome of the management in tetanus. Study Design: A
prospective analytical case series study. Setting: Tetanus ward, DHQ Hospital, Punjab Medical College Faisalabad. Subjects & Method:
All cases during one year (Jan 2000 to 31 Dec 2000) presenting through emergency ward and referred cases were admitted and treated
in tetanus ward. The cases included in study were above 5 years of age. Results: Sixty cases (41 male and 19 females) were studied during
one year. Thirty cases were described as high risk. The classical symptoms; trismus, dysphagia and muscular spasm were present in all
cases. Twelve risk factors were high lighted in one year. Household injuries leading to septic wounds in males and illegal septic abortions
were concluded as the highest risk factors. Injuries inflicted after road traffic accidents in males presented with shortest incubation period
and were declared as higher risk factors, with 67% mortality. Eleven ladies with septic abortion were admitted and six out of them expired
(mortality rate 55%). Eleven patients presenting with no known injuries, five of them expired. The overall case fatality rate during one year
was 40%. Conclusion: We picked up twelve high risk factors during one year study and found that house hold injuries caused maximum
mortality (75%) in females and road traffic accident was fatal in males (67%) mortality. It was found that all the cases were non immunized.
The basis of prevention is immunization. Health education is required in our society to follow the immunization programme. The cost-effective
approach is required in our country to lessen the financial burden and reduce the hospital stay.